Key Vacancies Abound in Poloncarz Administration

By Tony Farina

March 3, 2015

Erie county Comptroller Stephan Mychajliw

The stories seemed to come out all too frequently about deaths and other medical emergencies at the Erie County Holding Center in Buffalo and at the orrectional Facility in Alden. But despite the tarnished history, there is still no chief medical officer in place to oversee the care of the more than 600 inmates routinely held at the Holding Center and the 800 or so prisoners often housed at the Correctional Facility.

The chief medical officer (CMO) position has been vacant for more than a year and the office of County Executive Mark Poloncarz said in a statement "it has been difficult to find an individual who is willing to do this kind of work, when opportunities available to such an individual in the private sector would be more lucrative and with a different clientele."

According to Peter Anderson, Poloncarz's press secretary, "the Erie County Department of Health continues to discuss the CMO position with potential partners and hopes to fill the position soon."

That sounds a lot like the response we received recently about two other key vacancies in the administration of the county executive, the Social Services and Mental Health posts which are currently served by an acting commissioner (Mental Health) and a holdover (Social Services) who couldn't be moved to Mental Health because of legislative opposition.

In the case of the correctional CMO, you would think a salary in the range of $150,000 would be able to attract a medical professional despite the bad history and inmate clientele, but so far, like in the other two cases, the job remains unfilled.

And in a recent report, a court-assigned monitor has indicated that he has concerns about the lack of a supervising doctor to oversee physicians and review new policies at the correctional facilities that have had so much trouble in the past even as some progress is evident.

Add the name of Erie County Comptroller Stefan Mychajliw to those expressing concern about the correctional CMO vacancy as the efforts to find a suitable candidate continue to founder.

"We've recommended that the county executive push to increase the salary of the CMO for the jail and Correctional Facility but so far he hasn't moved on it," said Mychajliw. "I'm sure if the position were to be filled it would cut down on the often frivolous visits to ECMC by inmates with no supervising physician on hand to make medical decisions on their care."

According to an audit he released in January, the county's cost for providing inmate health care at the Alden facility and the Holding Center over the three-year audit period was more than $24 million for medical services that included prescription drugs, hospitalization, transportation, surgery, testing and mental health evaluations.

The comptroller said the annual cost for providing care coverage averages $8 million, all of it coming from taxpayers. Mychajliw is calling on the state to have the inmates have some skin in the game when it comes to paying for their own health care.

"I'm very concerned about the real costs of providing health care for those who are incarcerated, and I want to help decrease these costs," the comptroller said in a statement accompanying the audit. "It only makes sense to me that inmates have some skin in the game when it comes to paying for their health care." If they have money to spend on snacks and candy at the jail, he said, they can afford a low co-pay.

Mychajliw said the audit disclosed that if "we can't measure it [cost], we can't manage it." He said that charging a co-pay to inmates would generate roughly $300,000 in annual revenue for the county and would discourage inmates from pursuing unnecessary medical services and procedures. Identifying inmates that are eligible for Medicaid and those with private health insurance would allow the county to avoid costs for those inmates.

In the meantime, the position remains vacant and lots of secrecy continues about the actual conditions inside the correctional facilities and the costs of taxpayers of inmate care that is being performed without the oversight of a correctional medical professional, a condition that seems unlikely to be settled soon as in the cases of the other two major vacancies in the administration.

The county executive is touting a report that Erie County will save $136 million in retiree health care costs in future years as a result of his administration settling union contracts. Mychajliw said he's glad the county executive listened to recommendations he made to cut things like massages and acupuncture early in his term and that previously had been pushed by former County Executive Chris Collins, a Republican like Mychajliw.